Withdrawal From Benzodiazepine Therapy

Abstract

To the Editor.— The report of three cases of psychosis following abrupt discontinuation of benzodiazepine therapy (237:36, 1977) could be misleading because of the use of this unfortunate term. What the authors observed was the same spectrum of psychic symptoms repeatedly reported from reactions to alcohol or other sedativehypnotic drugs. Acute brain syndrome due to drug withdrawal is a much more precise phrase. Psychotic symptoms have not been prominent in the relatively few reactions to benzodiazepines reported in the medical literature since our first experimental study (Psychopharmacologia2:63-68, 1961). These reactions are modified in severity and attenuated over time because of the long persistence of the drug and its active metabolites in the body. Withdrawal reactions are dependent on high dosage of drug sustained rather constantly over time, with rapid rate of disappearance of the drug when it is discontinued. Drugs such as the benzodiazepines (or phenobarbital)